Abstract

Is therapeutic exercise of benefit? A summary of systematic reviews on therapeutic exercise published from 2002 to September 2005. People with neurological, musculoskeletal, cardiopulmonary, and other conditions who would be expected to consult a physiotherapist. Therapeutic exercise was defined as the prescription of a physical activity program that involves the client undertaking voluntary muscle contraction and/or body movement with the aim of relieving symptoms, improving function or improving, retaining or slowing deterioration of health. Effect of therapeutic exercise in terms of impairment, activity limitations, or participation restriction. The search yielded 38 systematic reviews of reasonable or good quality. The results provided high level evidence that therapeutic exercise was beneficial for patients across broad areas of physiotherapy practice, including people with conditions such as multiple sclerosis, osteoarthritis of the knee, chronic low back pain, coronary heart disease, chronic heart failure, and chronic obstructive pulmonary disease. Therapeutic exercise was more likely to be effective if it was relatively intense and there were indications that more targeted and individualised exercise programs might be more beneficial than standardised programs. There were few adverse events reported. However, in many areas of practice there was no evidence that one type of exercise was more beneficial than another. Therapeutic exercise was beneficial for patients across broad areas of physiotherapy practice. Further high quality research is required to determine the effectiveness of therapeutic exercise in emerging areas of practice.

Highlights

  • The analysis and treatment of movement problems is a major focus of physiotherapy practice (Jensen et al 1999)

  • A summary of the effect of therapeutic exercise by health condition can be viewed in Table 8

  • strong evidence that therapeutic exercise was effective for patients with multiple sclerosis

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Summary

Introduction

The analysis and treatment of movement problems is a major focus of physiotherapy practice (Jensen et al 1999). Physiotherapists use a number of approaches to managing movement disorders, and the prescription of exercise is one of the most common. A recent summary of systematic reviews on the effects of exercise in disorders commonly managed by physiotherapists concluded that exercise was beneficial for people with a range of chronic conditions (Smidt et al 2005). Conclusions based on a systematic review of randomised controlled trials are considered to provide the highest level of evidence about the effectiveness of an intervention (NHMRC 1999). Given the growth in the numbers of published systematic reviews and randomised controlled trials in physiotherapy since that time, it is necessary to provide clinicians and policy makers with the most up to date evidence about the effectiveness of our interventions. The research question for this study was: 1. Is therapeutic exercise of benefit in reducing impairment, improving activity, and increasing societal participation for people who would be expected to consult a physiotherapist?

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